REVIEW – December 2015

Remote ischaemic preconditioning – a simple method to reduce injury in target organs

Authors: Teele Kepler, Karl Kuusik, Jaan Eha, Mihkel Zilmer, Urmas Lepner, Joel Starkopf, Jaak Kals

Articles PDF


Remote ischaemic preconditioning (RIPC) is a method used to reduce ischaemicreperfusion injury in target organs. The method comprises short-term episodes of ischaemia, mostly of the extremities. The protective effect and mechanisms of RIPC have been studied in animals as well as in humans. In the latter, promising results have been demonstrated, especially for the heart and kidneys, but also for protection of other organs. The benefits of RIPC have been studied most extensively in cardiovas- cular surgery and percutaneous coronary interventions. Recently, the efficiency of RIPC has been noted in reducing contrastinduced nephropathy and in emergency procedures. The exact mechanisms of RIPC are not known, but it is clear that several different pathways are involved. The role of humoral and neural factors, as well as of the inf lammatory response, has been demonstrated in several studies.